ABSTRACT - University of the West Indies...Available alveolar bone width and height were measured on preoperative CBCT images. Marginal bone loss around dental implants was measured

West Indian Med J DOI 107727wimj2018068

The Effects of Different Variables on Marginal Bone Loss around Dental Implants

BK Orhan1 G Sonmez2 MO Ozemre1 C Koseoglu Secgin1 K Kamburoğlu2 A Gulsahi1

ABSTRACT

Objective To assess the effects of different variables including implant type and thread design bone width

and height measured on cone beam computed tomography (CBCT) images along with systemic and patient

related factors on marginal bone loss around dental implants which were measured on postoperative

panoramic radiographs

Methods A total of 116 dental implants from two manufacturers were used in the study Age gender history

of diabetes mellitus and hypertension smoking habit implant thread type implant site length and diameter

were recorded Available alveolar bone width and height were measured on preoperative CBCT images

Marginal bone loss around dental implants was measured on the panoramic radiographs taken three months

after implant placement on both mesial and distal sides

Results There were no statistically significant differences for the measurements of marginal bone loss on

both distal and mesial sides according to gender region jaw and implant type While there was a significant

difference between patients with and without diabetes mellitus in terms of distal marginal bone loss

(p lt 005) no significant difference was found between patients with and without diabetes mellitus for mesial

marginal bone loss The mean of marginal bone loss was 143 plusmn 075 mm and 145 plusmn 075 at the distal and

mesial sides respectively We found statistically significant differences for alveolar width and marginal bone

loss However no significant differences were found for the height measurements

Conclusion Marginal bone loss increased with an increase in bone width There were no significant

differences for the measurements of marginal bone loss on both distal and mesial sides according to gender

region jaw and implant type

Keywords Bone loss cone beam computed tomography dental implants panoramic

radiography

From 1Department of Dentomaxillofacial Radiology Faculty of Dentistry Başkent University Ankara

Turkey and 2Department of Dentomaxillofacial Radiology Faculty of Dentistry Ankara University Ankara

Turkey

Correspondence Dr MO Ozemre Dentomaxillofacial Radiology Faculty of Dentistry Baskent University

82 sokak No 26 Bahcelievler Cankaya Ankara Turkey Tel 0090 312 203 00 051609

Email mehmetozgurozemreyahoocom

E-pu

blish

ed a

head

of p

rint

Assessment of Marginal Bone Loss around Dental Implants

2

INTRODUCTION

Cone beam computed tomography (CBCT) systems operate by focusing a cone-shaped beam

on a two-dimensional detector that performs one pass or less around the patientrsquos head to

produce a series of 2-D images The use of special algorithms allows conventional axial plane

reconstructions along with multi-planar reformatted 2-D 3-D and panoramic reconstructions

which can be utilized for dental implant planning and placement (1‒3) Cone beam computed

tomography has largely replaced medical multislice tomography for most dental diagnostic

tasks and is now commonly used for a variety of purposes in oral implantology Cone beam

computed tomography images were found to be successful when used for linear measurement

of implant sites Cone beam computed tomography has also been shown to provide reliable

3-D information for the assessment of relative bone quality and quantity evaluation of ridge

topography and identification of vital anatomical structures such as the inferior alveolar nerve

mental foramen incisive canal maxillary sinus ostium and nasal cavity floor (4 5)

Information obtained from CBCT data can be used in the treatment planning process to

identify appropriate implant sites and to determine whether or not there is a need for sinus lifting

and bone augmentation (4 5) Cone beam computed tomography should only be used if two-

dimensional techniques have been unsuccessful to assess bone-implant interface (4) and to

identify peri-implant defects due to concerns over dose and metal artifacts caused by

implants(6)

Successful dental implant placement requires long-term maintenance of the soft and

hard tissue surrounding the implant Until recently various parameters such as mobility pain

infection inflammation and marginal bone levels were assessed as success criteria

(7‒9) Recently authors proposed a new classification and assessed implant success according

to three subtitles as follows patient-reported outcome measures implant-supported restoration

E-pu

blish

ed a

head

of p

rint

Orhan et al

3

and peri-implant health (10) Specific interest and attention was directed towards peri-implant

health and radiographic measurement of marginal bone levels since amount of bone around

implants may effect mechanical stability and dental esthetics (11) Radiography is of paramouth

importance in monitoring changes in the amount of marginal bone surrounding the implant after

implant insertion Intraoral imaging provides the best spatial resolution of any imaging method

currently available for the evaluation of marginal bone around implants The clinical diagnostic

capacity of intraoral radiography is influenced by a number of variables including beam

angulation exposure time receptor sensitivity processing viewing conditions

superimposition of anatomic structures and lesion location (12‒15) In routine clinical practice

panoramic radiography which is able to provide broad coverage of both jaws and teeth but

without the anatomical detail available with intraoral radiography is frequently utilized for

postoperative implant placement

Vertical bone loss at the surfaces facing implants should not exceed 1ndash2 mm during the

first year of function and 02 mm thereafter (16) A decrease in bone level indicates a loss in

the implantrsquos bony anchorage In order to gain more insight into the factors affecting the

marginal bone loss around dental implants long-term clinical evaluation of dental implants and

their superstructure is necessary Therefore the aim of this retrospective study was to assess

the effects of different variables including implant type and thread design bone width and bone

height measured on CBCT images along with systemic and patient related factors on marginal

bone loss around dental implants which were measured on postoperative panoramic

radiographs

MATERIALS AND METHODS

After receiving local ethical approval a total of 116 patients (56 women and 60 men) who had

been placed 116 dental implants with pre-operative CBCTs and three months postoperative

E-pu

blish

ed a

head

of p

rint


4

panoramic radiographs were evaluated retrospectively All implants were placed according to

manufacturer recommendations at a private clinic by an experienced surgeon with 20 years of

experience by using two different dental implants with two different thread designs

In this study 116 dental implants were used from two manufacturers 64 were MIS

(MIS Implants Technologies Ltd Shlomi Israel) [diameter range 35ndash5 mm length range

8ndash115 mm] and 52 were Oxy Implants (Biomec SRL Colico Italy) [diameter range 35ndash5

mm length range 85ndash13 mm] with aggressive thread design Age gender history of diabetes

mellitus and hypertension smoking habit implant thread type (normal or aggressive) implant

length and implant diameter and implant site (maxilla or mandible anterior or posterior) were

recorded for each patient In addition measurements of available alveolar bone width and

height were measured on cross-sectional preoperative CBCT images which were obtained by

using Iluma CBCT Unit (IMTEC Ardmore OK USA) and dedicated software Prior to

measurements section thickness and interval were set 01 mm Available alveoler width

measurements were performed at coronal middle and apical regions of alveoler bone Available

alveolar height measurements were performed from 1 mm below the top of alveolar crest to

apical part of the alveolar bone (Fig 1) In addition marginal bone loss around dental implants

was measured on the panoramic radiographs obtained with Planmeca Promax (Planmeca

Helsinki Finland) at 54 kVp 5mA and 158 seconds Three months after implant placement by

using dedicated software For each implant postoperative measurements of marginal bone loss

were performed on both mesial and distal point of the implant platform to the crestal bone

Calibration was performed using the known lengths of the inserted implants (Fig 2) All CBCT

and panoramic measurements were performed three times by a single observer an oral

radiologist and average calculated To assess intra observer agreement the measurements were

repeated by the same observer after two weeks

E-pu

blish

ed a

head

of p

rint

Orhan et al

5

Fig 1 Available alveolar height and width measurements from cone beam computed tomography images are

shown

Fig 2 Implant length measurement (163mm) for calibration by using the known lengths of the inserted implant

and marginal bone loss measurement (13 mm) from panoramic image

E-pu

blish

ed a

head

of p

rint


6

Descriptive statistics were performed Comparison of distal and mesial measurements was

conducted by using Mann-Whitney U test and Kruskal-Wallis variance analysis

Pearson correlation was used to assess the relationship between implant site and bone loss

Statistical significance was set p lt 005

RESULTS

Table 1 shows the demographic information of the patients

Table 1 The demographic information of the patients

TABLE 1 n()

Gender Female Male Implant Site Right Left Jaw Maxilla Mandible Region Molar Premolar Anterior Implant type MIS OXY Diabetes Mellitus Present Absent Hypertension Present Absent Smoking Habits Non-smoker Half package per day One package per day

56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)

Table 2 reveals mean median minimum and maximum values of distal and mesial marginal

bone loss and their standard deviations in terms of gender jaw and implant related factors

E-pu

blish

ed a

head

of p

rint

Orhan et al

7

There were no significant differences for the measurements of marginal bone loss on both distal

and mesial sides according to gender implant site jaw region and implant type (p gt 005)

Table 2 The mean median mimimum and maximum values of distal and mesialmarginal bone

loss and their standard deviations in terms of gender jaw and implant related factors

Table 3 shows the distal and mesial marginal bone loss according to diabetes mellitus

hypertension and smoking habits There was a significant difference between patients with and

without diabetes mellitus in terms of distal marginal bone loss (p lt 005) However we found

no significant difference between patients with and without diabetes mellitus for mesial

marginal bone loss (p gt 005) In addition no significant differences were found among patients

with and without hypertension patients with and without smoking habits according to both

distal and mesial marginal bone loss

Marginal Bone Loss Distal

Parameters MeanplusmnSD Median (Min-max)

Marginal Bone Loss Mesial

MeanplusmnSD Median (Min-max)

Gender Female Male p Implant Site Right Left p Jaw Maxilla Mandible p Region Molar Premolar Anterior p

149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370

149plusmn083 123 (040-450) 149plusmn089 118 (045-50) 142plusmn065 125 (041-389) 140plusmn080 113 (037-399) 0586 0725

134plusmn069 121 (040-450) 140plusmn085 115 (037-420 154plusmn080 154 (043-389) 150plusmn086 118 (046-50) 0165 0449

141plusmn083 125 (040-450) 139plusmn096 110 (046-50) 142plusmn064 125 (052-291) 154plusmn083 127 (037-399) 148plusmn078 125 (056-350) 139plusmn063 120 (048-291) 0777 0469

Implant Type MIS OXY p


E-pu

blish

ed a

head

of p

rint


8

Table 3 The distal and mesial marginal bone loss according to diabetes mellitus hypertension

and smoking habits

Parameters

Marginal Bone Loss Marginal Bone Loss Distal Mesial

MeanplusmnSD Median (Min-max) MeanplusmnSD Median (Min-max) Diabetus Mellitus Absent Present

p Hypertension Absent Present

p Smoking Habits Non smoker Half package perday One package perday

p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543

129plusmn088 105 (046-420) 152plusmn084 122 (037-500) 151plusmn081 127 (059-282) 0100

0036

141plusmn071 125 (041-450) 179plusmn126 138 (040-350) 0626 136plusmn093 112 (040-450) 148plusmn063 143 (046-340) 130plusmn077 090 (043-291) 0145

The mean and standard deviation of marginal bone loss was 143 plusmn 075 and 145 plusmn 085 mm at

the distal and mesial sides respectively No significant difference was found between mesial

and distal marginal bone loss

Table 4 shows the alveolar width and height measurements in both mesial and distal

sides We found a positive correlation between alveolar width measurements (except mesial

apical width) and marginal bone loss However no significant differences were found for the

height measurements (p gt 005)

Table 4 The alveolar width and height measurements in both mesial and distal sides

Distal Side Mesial Side

Width (apical) Width (middle) Width (coronal) Height

r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION

We assessed the effects of insertion site implant type and thread design bone width and bone

height measured on CBCT images along with gender and patient related factors on marginal

bone loss around dental implants in the maxilla or in the mandible Since clinical oral implant

success requires maintenance of the immobility of individual implants marginal bone loss

around dental implant is among the most important factors for the assessment of treatment

outcome (17) In this retrospective study it was neither possible nor practical to determine the

actual marginal alveolar bone loss at the distal and mesial sites As a result the diagnostic

accuracy of the methods was not assessed and a gold standard was not established We did not

perform postoperative CBCT imaging as it is not the modality of choice for postoperative

implant assessment due to radiation concerns and technical issues related to beam hardening

artefacts A drawback of panoramic radiography chosen for the present study was that a

magnifying factor associated with image formation and projection geometry results in image

distortion and a marked overlapping of tooth crowns Only one implant was choosen for each

patient and calibration of panoramic images which are frequently utilizied for postoperative

implant assessment was performed mathematically based on the known lengths of the implants

A previous study found no significant difference for patients or for implants for the

advanced surgery cases or the conventional approach in diabetic patients compared to non

diabetic patients (18) The overall survival rate for the diabetic group was 972

(control 988) and was not significantly different for age gender diabetes duration smoking

or type of hypoglycaemic therapy The mean peri-implant bone loss was 041 plusmn 058 mm

(control 049 plusmn 064 mm) Similarly we found no statistically significant difference between

patients with and without diabetes mellitus for marginal mesial bone loss (p gt 005) In the

present study we did not assess information regarding the blood tests and related values of the

E-pu

blish

ed a

head

of p

rint


10

patients and therefore our findings regarding diabetes mellitus were based on only patientsrsquo

history In addition we found no significant differences among patients with and without

hypertension patients with and without smoking habits and patients who were smokers and had

hypertension in terms of both distal and mesial marginal bone loss measurements

A study found that the mean bone loss around implants was 0553 mm on mesial aspect

and 0503 mm on distal aspect The p-value for both mesial and distal aspect of implant was

found to be statistically non-significant The mean bone loss on mesial aspect of implants was

0601 mm for maxillary implants and 0473 mm form and ibular implants whereas the mean

bone loss on distal aspect of implants was 0481 mm for maxillary implants and 0541 mm for

mandibular implants (19)The p-values for both mesial and the distal aspect of implant were

found to be statistically non-significant analogous to our findings In the present study

calculated mean and standard deviation measurements of marginal bone loss was 143 plusmn 075

and 145 plusmn 085 mm at the distal and mesial sides three months after insertion Higher bone loss

found in our study might be due to the fact that we measured bone loss three months after

implantation whereas in the mentioned study authors measured bone loss one year after

implantation

In the present study only one experienced expert evaluated the images in order to

eliminate observer bias However when a decision could not be made by the observer a second

decision was made by another researcher In a study that examined the accuracy and quality of

both 2D and 3D measurement techniques simulated peri-implant defects were measured using

2D intraoral radiography and panoramic radiography as well as 3D computerized

tomography(CT) and digital volumetric tomography (20)With both CT and dental volumetric

tomography scans bone defects could be measured in all three planes and showed only slight

mean deviations when compared with direct measurement (CT 017 plusmn 011mm dental

E-pu

blish

ed a

head

of p

rint

Orhan et al

11

volumetric tomography 018 plusmn 012 mm) With intraoral radiographic and panoramic

radiographic images the defects could be detected in only themesiodistal and craniocaudal

planes and showed greater mean deviations when compared with direct measurement (intraoral

radiography 034 plusmn 030 mm panoramic radiography 041 plusmn 035 mm)Although dental

volumetric tomography provides images in three planes without distortion it is not always

appropriate or possible to use in routine clinical practice because of higher radiation doses when

compared with intraoral radiography as well as high costs and lack of availability (20)

We found that the increase in marginal bone loss overtime was found to be correlated

with width on both sides however no correlation was found for height variable Marginal bone

loss increased with an increase in bone width There were no statistically significant differences

for the measurements of marginal bone loss on both distal and mesial sides according to gender

region jaw and implant type Further studies are essential to fully understand the parameters

which may have an effect on marginal bone loss around implants

ACKNOWLEDGEMENTS

There is no acknowledgements and financial supports

AUTHOR CONTRIBUTION

MO Ozemre and BK Orhan participated in study design data collection data analysis and

interpretationG Sonmez and C Koseoglu Secginparticipated in data interpretation K

Kamburoglu and A Gulsahi oversight to study participated in data interpretation and revision

of manuscript and approved final version The authors declare that they have no conflicts of

interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES

1 White SC Cone-beam imaging in dentistry Health Physics 2008 95 628-637

2 Scarfe WC Farman AG Levin MD Gane D Essentials of maxillofacial cone beam

computed tomography Alpha Omegan 2010103 62-67

3 Scarfe WC Farman AG What is cone-beam CT and how does it work Dent Clin North

Am 200852(4)707ndash30

4 Benavides E Rios HF Ganz SD An CH Resnik R Reardon GT Feldman SJ Mah JK

Hatcher D Kim MJ Sohn DS Palti A Perel ML Judy KW Misch CE Wang HL Use of

cone beam computed tomography in implant dentistry The international congress of oral

implantologists consensus report Implant Dent2012 21(2)78-86

5 Baciut M Hedesiu M Bran S Jacobs R Nackaerts O Baciut G Pre- and postoperative

assessment of sinus grafting procedures using cone-beam computed tomography compared

with panoramic radiographs Clin Oral Implants Res 201324(5)512-6

6 Mengel R Kruse B Flores de Jacoby L Digital volume tomography in the diagnosis of

peri-implant defects an in vitro study on native pig mandibles J Periodontol 2006771234-

41

7 Jones AA Cochran DL Consequences of implant design Dent Clin North Am

200650339ndash60

8 Mombelli A Lang NP Clinical parameters for the evaluation of dental implants

Periodontol 20001994481ndash86

9 Chung WE Rubenstein JE Phillips KM Raigrodski AJ Outcomes assessment of patients

treated with osseointegrated dental implants at the University of Washington Graduate

Prosthodontic Program 1988 to 2000Int J Oral Maxillofac Implants 200924(5)927-35

E-pu

blish

ed a

head

of p

rint

Orhan et al

13

10 Tonetti M Palmer R Working Group 2 of the VIII European Workshop on

PeriodontologyClinical research in implant dentistry study design reporting and outcome

measurements consensus report of Working Group 2 of the VIII European Workshop on

PeriodontologyJ Clin Periodontol 201239(supply 12)73-80

11 Nisapakultorn K Suphanantachat S Silkosessak O Rattanamongkolgul S Factors affecting

soft tissue level around anteriormaxillary single-tooth implantsClin Oral Implant

Res201021(6)662-70

12 Kamburoğlu K Barenboim SF Kaffe I Comparison of conventional film with different

digital and digitally filtered images in the detection of simulated internal resorption cavities-

an ex vivo study in human cadaver jaws Oral Surg Oral Med Oral Pathol Oral Radiol

Endod 2008105790-97

13 Kamburoğlu K Tsesis I Kfir A Kaffe I Diagnosis of artificially induced external root

resorption using conventional intraoral film radiography CCD and PSP an ex vivo study

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008106885-91

14 Kamburoğlu K Cebeci AR Groumlndahl HG Effectiveness of limited cone-beam computed

tomography in the detection of horizontal root fracture Dent Traumatol200925256ndash61

15 Tsesis I Kamburoğlu K Katz A Tamse A Kaffe I Kfir A Comparison of digital with

conventional radiography in detection of vertical root fractures in endodontically treated

maxillary premolars an ex vivo study Oral Surg Oral Med Oral Pathol Oral Radiol

Endod2008106124-28

16 Smith DE Zarb GA Criteria for success of osseointegrated endosseous implants J Prosthet

Dent 198962567ndash72

17 Zarb GA Albrektsson T Consensus report towards optimized treatment outcomes for

dental implants J Prosthet Dent 199880(6)641

E-pu

blish

ed a

head

of p

rint


14

18 Tawil G Younan R Azar P Sleilati G Conventional and advancedimplanttreatment in

the type II diabetic patient surgical protocol and long-term clinical results Int J Oral

Maxillofac Implants 200823(4)744-52

19 Nandal S Ghalaut P Shekhawat HA radiologicalevaluation of

marginalbonearounddentalimplants An in-vivostudy Natl J Maxillofac Surg

20145(2)126-37

20 Mengel R Kruse B Flores-de-Jacoby L Digital volume tomography in the diagnosis of

peri-implant defects an in vitro study on native pig mandibles J Periodontol

2006771234ndash41

E-pu

blish

ed a

head

of p

rint


2

INTRODUCTION

Cone beam computed tomography (CBCT) systems operate by focusing a cone-shaped beam

on a two-dimensional detector that performs one pass or less around the patientrsquos head to

produce a series of 2-D images The use of special algorithms allows conventional axial plane

reconstructions along with multi-planar reformatted 2-D 3-D and panoramic reconstructions

which can be utilized for dental implant planning and placement (1‒3) Cone beam computed

tomography has largely replaced medical multislice tomography for most dental diagnostic

tasks and is now commonly used for a variety of purposes in oral implantology Cone beam

computed tomography images were found to be successful when used for linear measurement

of implant sites Cone beam computed tomography has also been shown to provide reliable

3-D information for the assessment of relative bone quality and quantity evaluation of ridge

topography and identification of vital anatomical structures such as the inferior alveolar nerve

mental foramen incisive canal maxillary sinus ostium and nasal cavity floor (4 5)

Information obtained from CBCT data can be used in the treatment planning process to

identify appropriate implant sites and to determine whether or not there is a need for sinus lifting

and bone augmentation (4 5) Cone beam computed tomography should only be used if two-

dimensional techniques have been unsuccessful to assess bone-implant interface (4) and to

identify peri-implant defects due to concerns over dose and metal artifacts caused by

implants(6)

Successful dental implant placement requires long-term maintenance of the soft and

hard tissue surrounding the implant Until recently various parameters such as mobility pain

infection inflammation and marginal bone levels were assessed as success criteria

(7‒9) Recently authors proposed a new classification and assessed implant success according

to three subtitles as follows patient-reported outcome measures implant-supported restoration

E-pu

blish

ed a

head

of p

rint

Orhan et al

3





















radiographs




E-pu

blish

ed a

head

of p

rint


4

























E-pu

blish

ed a

head

of p

rint

Orhan et al

5


shown



E-pu

blish

ed a

head

of p

rint


6





RESULTS



TABLE 1 n()


56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)



E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

3





















radiographs




E-pu

blish

ed a

head

of p

rint


4

























E-pu

blish

ed a

head

of p

rint

Orhan et al

5


shown



E-pu

blish

ed a

head

of p

rint


6





RESULTS



TABLE 1 n()


56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)



E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


4

























E-pu

blish

ed a

head

of p

rint

Orhan et al

5


shown



E-pu

blish

ed a

head

of p

rint


6





RESULTS



TABLE 1 n()


56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)



E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

5


shown



E-pu

blish

ed a

head

of p

rint


6





RESULTS



TABLE 1 n()


56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)



E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


6





RESULTS



TABLE 1 n()


56 (483) 60 (517) 62 (534) 54 (466) 64 (552) 52 (448) 50 (431) 43 (371) 23 (198) 52 (448) 64 (552) 102 (879) 14 (121) 109 (94) 7 (6) 37 (319) 70 (603) 9 (78)



E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

7

















149plusmn076 140(040-450) 120plusmn063 115 (041-291) 0075

150plusmn089 120 (037-50)

124plusmn063 111 (045-273) 0370






E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


8


and smoking habits

Parameters





p

139plusmn076 122 (040-450) 172plusmn060 180 (077-320)

140plusmn079 117 (037-420) 177plusmn116 177 (050-500)

0342 145plusmn083 117 (037-500 140plusmn117 110 (068-399)

0543


0036












r p r p 0235 0011 0052 0581

0283 0002 0252 0006 0213 0022 0235 0011 0118 0207 0137 0143

p lt 005

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

9

DISCUSSION
























E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


10
















implantation









E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

11














ACKNOWLEDGEMENTS


AUTHOR CONTRIBUTION





interest

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


12

REFERENCES





Am 200852(4)707ndash30










41


200650339ndash60






E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Orhan et al

13







Res201021(6)662-70




Endod 2008105790-97









Endod2008106124-28





E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint


14






20145(2)126-37



2006771234ndash41

E-pu

blish

ed a

head

of p

rint

Documents

ABSTRACT - University of the West Indies...Available alveolar bone width and height were measured on preoperative CBCT images. Marginal bone loss around dental implants was measured